A statewide program helps improve the lives of first-time mothers and their children

Karla Andazola left and her son Adan completed Children First, Oklahoma’s family-nurse partnership program, in June. Spring Hodges right was their home visiting nurse. (Laura Eastes)

There’s a story told about starfish in social services and philanthropic circles. A boy walks down the beach as he pauses to toss starfish back into the ocean after the tide stranded them in the sand. A skeptic points out that with thousands of them wilting in the sun, his effort probably won’t make much of a difference.

The child picks up another, launches it to sea and replies, “It made a difference to that one.”

That’s Children First, making a measurable impact on the lives of children, mothers, families and the communities in which they live since 1997, explained Denise Howard, program administer for Oklahoma City-County Health Department (OCCHD).

“We can’t reach every family, and we can’t make a difference in every single child’s life, but we know we are making a difference in the lives that we do touch,” Howard said.

Poverty is a vicious cycle with multiple elements — underemployment, financial hardship, poor health and housing, child maltreatment, domestic violence, lack of self-worth and hopelessness — that combine to form a rising tide. Programs like Children First, supported by two-generational, evidence-based methods, can stem that tide and even reverse poverty and its effects.

“We feel the change goes from generation to generation,” Howard said. “We can help change the trajectory for families.”

In 2016, Howard and a team of 15 home-visiting nurses served 558 Oklahoma County mothers and their children, answered pregnancy questions and marked child development milestones. A statewide program administered by the Oklahoma State Department of Health, Children First impacted more than 2,500 families and made 26,729 home visits last year, according to state records.

Poverty and pregnancy

As a deterrent to child maltreatment and to improve Sooner children’s health and well-being, Children First was created in 1996 under the direction of the Oklahoma Legislature.

It was one of the first nurse-family partnerships programs in the nation and holds a mission to empower first-time parents “to care for themselves and their babies by providing information and education, assessing health, safety and development and providing linkages to community resources, thereby promoting the well-being of families through public health nurse home visitation, ultimately benefitting multiple generations.”

Now, families in more than 40 states welcome nurses into their homes starting early in mothers’ pregnancies and continuing until the child turns 2.

In early 1997, Oklahoma’s Children First debuted its pilot program in four counties. Later that year, it expanded to Oklahoma County.

The program’s philosophy and mission is grounded in multiple studies that show families with low socioeconomic resources tend to have the worst health outcomes. The early child health consequences of poverty and pregnancy include greater risks for preterm birth, low birth rate and infant death.

In its 20 years, the program has consistently boosted the health of mothers, improved children’s well-being and safety and curbed child maltreatment, state reports show.

Funded by local, state and federal taxes, Children First is offered in 71 counties, including all seven metro OKC counties. Previously offered in each of Oklahoma’s 77 counties, the program has felt the sting of state budget cuts in recent years.

The state reports the program’s cost per family is $3,739. National Institutes of Health analysis shows that, by 2031, nurse-family partnership programs will save the federal government $3 billion in spending on Medicaid, Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP), or food stamps. That same analysis also found the program will prevent as many as 500 infant deaths; 10,000 preterm births; 13,000 dangerous, closely spaced second births; 4,700 abortions and 42,000 child maltreatment incidents.

Modeling great parents

In Oklahoma County homes, Children First nurses address a variety of issues, from health and nutrition to employment and educational opportunities. Moms are encouraged to determine long-term goals, and the nurses then connect them with community resources to help the women achieve them.

“We educate the mothers throughout the pregnancy about what is normal, what to expect and when to be worried,” Howard said.

Following enrollment, a nurse visits weekly for the first four weeks and then every other week until the baby is born. The first six weeks after the baby is born, the nurse visits every week and then every other week until the infant reaches 21 months. Then, the nurse visits monthly until the child turns 2.

“Nurses give the client the choice of what they are interested in: ‘What can I answer for you; what would you like me to bring for our next visit?’” Howard said. “We cover the information and provide materials that the mom is interested in to help her be engaged and the best parent she can be.”

Graduate Karla Andazola credits Children First for helping her become a stronger parent and person. Andazola and her son Adan completed the program in June, and she said its influence continues. She said she often utilizes child development tips she learned and one of Adan’s favorite storytime books is one that nurse Spring Hodges brought with her during her visits.

“She was a nurse for him, but she was like my counselor,” Andazola said. “My child is not a perfect child, but she would watch to see how I handled him when he had a tantrum. She would acknowledge when I was doing good. I tried things I would have never tried if it weren’t for Spring. She was my backbone all along the way.”

Print headline: Building families, For 20 years, Oklahoma’s Children First partners with first-time, low-income moms and families to build safe, stable, healthy homes for children.